#COT2017

Whilst still on a high from being part of the Blog Squad for the Royal College of Occupational Therapists annual conference #COT2017. I am pondering on the idea of returning to blogging as a regular occupation.

There was an atmosphere of excitement as we all entered Hall 1at Birmingham’s ICC for the first session of this year’s RCOT conference #COT2017 and we were not to be disappointed. The first Keynote speaker was Paul McGee who inspired us, challenged us and made us laugh along the way. Paul is the Managing Director of PMA International which aims ‘to help people achieve better results in life and have fun in the process’. He is also known as the SUMO Guy. SUMO stands for ‘Shut up and move on’ and you can follow Paul on twitter @TheSumoGuy and his website is www.thesumoguy.com.

Paul had very engaging slides and used cartoons, some of which can be viewed in this pdf from his website. ‘Faced with a challenge? 7 questions to help you.’ He got the audience engaged from the get go by us making stand and repeat a phase to a partner – we very trustingly did this but then wandered what on earth we had just said as it was in a foreign language. This turned out to be Norwegian for ‘I love you sugar babe’! Paul then told us that the word inspire means ‘to breathe life into’ and that is what he understood occupational therapists aim to do. This set the scene for the conference as ‘inspire’, ‘inspiring’ and ‘inspirational’ all became words I heard and saw tweeted a lot of the course of the conference.

Not satisfied in making us speak Norwegian, Paul then got us to repeat another phrase after him – this time we were asked to repeat to each other that we were utterly and completely Mad! Fortunately, MAD turned out to stand for ‘Making a Difference’. Next, Paul asked us to focus on our attitudes and thoughts and to ‘Mind our mindset.’ He suggested that we need to evaluate the challenges we are dealing with and put them in perspective. We were asked to try evaluating a current challenge on a scale of 1 to 10, where 10 = death.

Paul recommended that we try to push a few more doors because you only need one to open. This reminded me of Professor Peter Millard, my supervisor when I held a Senior I research post in the Department of Geriatric medicine at St Georges hospital. Prof Millard taught me this same lesson in 1990 about applying for research funds. The worse you may get back is a ‘no’ but this is worth the risk because of the greater potential benefits that can occur if a door does open. It is the ‘nothing ventured, nothing gained’ and ‘you have to be in it to win it mentality’

Paul also warned us against CNN = the barrage constant negative news we are now subjected to and encouraged us to remember the wonder and good in our world. So as we move forward we need to stop being on autopilot, take time to think, reflect and move on with more knowledge. Paul then put up my favourite moto on the screen ‘Carpe Diem’ (for anyone who hasn’t heard of this before it means ‘seize the day’). He reminded us that it doesn’t matter if we fall, but it’s how long you stay down that matters. So the SUMO Guy got us laughing, but also to stop, reflect and put our challenges into perspective. To hold on to our vision as occupational therapists and remember that we do make a difference and being MAD is good!

Our second Plenary Speaker was Dr Winnie Dunn from the University of Kansas, USA @winniedunn. Winnie is an internationally recognized research and expert in the field of sensory processing in everyday life and author of the Sensory profile measures.

As my own PhD related to test development and psychometrics and I am familiar with the sensory profile I was excited to hear her speak. Winnie emphasized that sensory processing is about everyone, not just those considered to be vulnerable or with a diagnosis associated with sensory processing difficulties. Children may process sensory information differently regardless of whether they are neurotypical. She summarised the evidence base from a comprehensive literature review and from data collected using the sensory Profile. I particularly liked how she made one of her points about not labelling clients based on their scores and distribution on the bell curve through using herself as an example.

We ended the session with a minutes silence to remember all those who have been affected by the recent Grenfell Tower fire disaster in North Kensington, London. I personally appreciated this quiet time to pray for all those involved and was glad COT included us in the Nation’s minute of silence.

Diane has posted a blog about her preparation for delivering this year’s Casson Memorial lecture – the ‘Before Casson Blog’. Alison has written two blogs on her impressions of the Casson both during and after the lecture.

The Before: The title of my Casson Memorial Lecture is “Life as an occupational being”, I approached this blog on the experience of delivering the Casson Memorial Lecture with this title in mind. When I found out I had been nominated and chosen to deliver the Casson I was delighted and terrified!

Over the year of preparation, I read, wrote, rewrote, read, and wrote again – the focus for me became the point of this being a lecture that is published and therefore written as a speech and then published in the British Journal of Occupational Therapy – I spoke to a number of past Casson lecturers and the advice was write for the day so that’s what I did.

Trying to decide what I wanted to say was the hardest decision as there were so many aspects of my life as an occupational being and our amazing occupational therapy profession I wanted to talk about – but I kept coming back to the importance of evidence and our need to investigate and publish what we do.

Once I had decided what I wanted to say then came the writing – the Casson is delivered as a lecture in its fullest sense. I needed to write a speech that could be delivered in 45 minutes and no more – how many words should it be? – advice I was given is somewhere around 5000 words as “the average person speaks at somewhere between 125 and 150 words per minute. It’s always better to speak more slowly than quickly”. Others told me to write too much and then cut it down – I’ve delivered many lectures, seminars, workshops over the years in practice and in education I have always tended to do the slides and then talk to the slides – I’d never before being mindful of every word – a new experience – a new occupation – one I am privileged to have experienced.

Diane Cox @dianecox61

During the Casson: 19th June 2017

I had been waiting in anticipation for today to arrive for a long while the day my brilliant colleague Professor Diane Cox delivers the Elizabeth Casson Memorial lecture. I had been given some hints – but what would she say? And how would she say it? It is hard to do a 45 minute lecture that has taken hours of consideration to write justice is a short blog – so here are a few of my highlights:

Diane reminded us of the important legacy that Dr Elizabeth Casson has left us. In her explorations of RCOT’s archive she had found an early publication of Dr Casson’s from 1941 began with the statement ‘Rehabilitation needs serious attention at present’ – and Diane challenged us to address this, as it is still so true today.

A significant portion of her lecture focused on the meaning of occupation for human beings and for occupational therapists and occupational therapy. Occupational and social interactions are essential to a person’s life. Diane shared a couple of quotes from other authors that really resonated with me: “Occupation is as old as humanity” (Reed et al, 2012) and from Brock (1934): “Occupation is not a secondary matter. It is a primary need of an individual’s life”. So we must keep occupation central in our practice and research.

For me, one of Diane’s most reassuring facts is that occupational therapy is the lowest risk job to be taken over by robots. However, we shouldn’t rest on our laurels because Diane told us that a challenge OTs face is that, although we are the profession at least at risk of being taken over by robots because of the highly complex nature of OT interventions, on the surface occupational therapy practice can look so simple. Diane shared one of her own photographs of a swan – it looks serene but all the power is hidden under the surface. So we have to learn to be able to articulate and evidence the complexity of our practice, particularly the parts of occupational therapy that are not easily discerned by others.

Her take home messages were very clear and the last one was given to us first in the lecture, as well as at the end: ‘Publish, publish, publish’! It is our responsibility as occupational therapists to provide the evidence base for the impact occupational therapy can make to enable people to be the occupational beings they need, want and are expected to be. Diane challenged every presenter at the COT to write their presentations up and submit for publication and to make a commitment to publish at least once a year. We must tell policy makers what OTs do and provide the evidence of our impact to influence policy direction. We also need to be able to summarise our practice and our research succinctly and know how to encapsulate what we do and why we do it. Like speed dating we need to get good at ‘speed describing’! Diane talked about the three minute thesis – can you do it? Can you define what you do, describe what you do – and could it be replicated? Your occupational therapy work or research summarised in 3 minutes? One way to try to summarise what you do is to organise it using PICO. P = patient, person, problem; I = the intervention; C = comparison intervention when relevant; and O is the outcome of interest. If you aren’t familiar with PICO you can find information here:

Diane finished by telling us that publishing should be part of our shared occupation and is part of our OT occupational being.

After the Casson: 21st June 2017

If you missed Diane’s Casson lecture or want to reflect on her messages further I’ve been told by BJOT’s editor that the Casson is usually published in the September issue of the British Journal of Occupational Therapy – it will definitely be on my ‘to read’ list. Inspiring was one of the words most frequently used in the comments made directly to Diane after the lecture and by people discussing the lecture as they left the auditorium. I’ve been following the resulting tweet chatter with interest to get a sense of the impression that this year’s Casson lecture has made on colleagues at conference. In the spirit of evidence based practice I set the question: ‘How have OTs reacted to the 2017 Casson Lecture’? I searched for posts citing @dianecox61 and / or the #COT2017 hash tag for evidence. After appraising the evidence here are my key findings. The message that we all should be publishing was definitely picked up on by the OT Twitterazzi. Several people posted Diane’s final slide on twitter and it is still being retweeted and commented on by others two days later. For example:

@SBtweetsOT tweeted: ‘After challenge yesterday from @dianecox61 to Publish Publish Publish I attended a workshop with BJOT editor-in-chief on just that!’

Miranda Thew @thewmiranda tweeted this afternoon: ‘@theRCOT Let’s see some of those inspirational ideas and research projects published!! As @dianecox61 urged!!’ But Channine Clark @channineclark appears to be the first person to report that Diane’s challenge has been actioned, as she posted at 4pm this afternoon:‘Following advice of @dianecox61 and submitted to BJOT this morning a paper highlighting issues of occupational deprivation on hospital wards.’

So whether you are a clinician, manager, educator or researcher – as Jo Webb tweeted today in response to Clare Taylor’s @ClareTaylorBU tweet of ‘one publication a year’ …

Thank you to everyone who attended this occupation station session with Dr Susan Burwash (@subu_OT). Special thanks to Clare Taylor (@ClareTaylorBU) for not only ensuring we were all hydrated and fully able to engage in the session, but for tweeting so much of the session so I could just ‘do’.

Aim: To discuss and demonstrate how creating a variety of simple, low-cost beads in therapy can contribute to enhanced client self-knowledge, goal identification and to taking hopeful action towards achieving desired outcomes.

Background: The occupation is fabricating beads as a component of jewelry-making. Jewelry-making has been used by occupational therapists since the early days of the profession (Kidder, 1922). However, as contemporary therapists are not often exposed to jewelry-making in their education, and as fewer occupational therapy departments have jewelry-making tools/materials because of cost/space requirements, use of this occupation in therapy may not be as common as it could be. Jewelry-making remains a popular leisure activity, may be associated with cultural practices, and can also be a source of income. An occupation that can be done individually or within a group setting, it can be used to explore self and communicate complex ideas visually. While some beadmaking processes require great skill and specialised tools, there are many beads that can be created using simple techniques and inexpensive materials. This Occupation Station will demonstrate a variety of beads, allow attendees to create one of the beads
demonstrated, and discuss therapeutic purposes to which making beads and jewelry could contribute.

For further information and insights into Dr Burwash’s work I highly recommend you take a look at the following article:

It all began with my journey to Birmingham. Well actually, it started way before that. I expressed my interest in going to the conference last year and I was lucky enough for the department I work in to fund it. From then the reality hit that, as exciting as it was going to be, it was also nerve wracking. I wouldn’t know a single person going. This leads me to provide my first tip to new conference goers: network beforehand! Make connections through twitter, join in tweet chats and get involved. That is how I came to be involved in writing these blogs. So I arrived at Birmingham after a 4 hour bus journey and made my way to the ICC to register early. I met with a welcoming group of #OTalk Occupational Therapists, organised through twitter, and went out for dinner. This helped ease the fear that I would spend the entire two days walking around on my own! A great start to the days to come…

Monday 19th June – Conference Day 1

I am a super organised person so I’d mapped the whole two days out in a pocket sized timetable for myself. The Book of Abstracts created by the conference team as invaluable. There are a huge range of sessions covering a variety of areas you may not have even considered! I balanced things that would directly benefit me professionally in my current workplace and things that just sounded fascinating.

The opening plenary session was uplifting and inspiring and set the mood for the rest of the conference. Don’t forget to have a look at the #OTalk blog posts that cover a HUGE variety of sessions.

Competition was fierce to get into sessions and it paid to be organised by knowing what I wanted to attend, the timings and where to go – that is certainly my second tip for attending! As a third tip – have a back-up plan in case your first choice session is full when you get there.

S29: The Elizabeth Casson Memorial Lecture – Life as an occupational being by Professor Diane Cox.

S30A: Occupation Station – a practical session where we made a stop motion animation of a blooming flower.

I also took time to view the posters, the mini A4 versions to take away is a brilliant idea! The day passed surprisingly quickly considering how packed it was. For me it finished with the welcome drinks, for others it went on into the night with the Conference Party – something I’ll definitely go to in the future.

Tuesday 20th June – Conference Day 2

Conference started at 8.30am with another jam-packed day of sessions. I gave myself a few breaks today as I was flagging from the sheer amount of information I had taken! This time wasn’t wasted, I networked with other delegates, visited the stands, signed up to the Mental Health Specialist Section. I also collected lots of goodies to take back to the Occupational Therapists at work – pens, badges and post-it notes galore!

Today I attended the following session:

S54: Brag and Steal – 4 innovative practice examples that Occupational Therapists are proud of and want to share.

The closing plenary was just as uplifting at the opening one and I left with mountains of information to share with the many amazing Occupational Therapists I work alongside. Here’s hoping I can attend next years conference in Belfast!

As an Occupational Therapist working in the NHS I have seen many staff become burnt out or trying to attend work and “soldier on” when really they should be anywhere but at work. I’ve observed lots of things put on offer by the NHS for managing staff sickness for example counselling sessions, supervision, occupational health etc. However it’s always struck me that not a lot has been done to prevent workers getting to this point and the literature in Occupational Therapy involvement is scarce. When I saw this talk in the programme I knew I had to attend.

Miranda described in her talk how many companies offered tele-care for their staff, this was seen as a tick box measure to say that staff were offered support. This is neither effective or personal. It also does not address the issue of presenteeism – attending work when a person’s mind is not on the job and really should be on sick leave. Presenteeism leads to a decrease in productivity and becoming a burden for the team – ultimately leading to dysfunctional unhealthy teams. Companies however are very focussed on absence rates. Miranda discussed that once presenteeism was described to employers she received comments such as “ah yes I have 6 of those”. They could see that something else had to be done. This concept also had to be sold to companies using their own language – using words such as resilience resonates with companies who will commission services.

The course consists of a closed group with 6 sessions that were 2 hours long and which took place every other week. The key was that it was in the workplace, people wanting to attend snowballed from the first group through word of mouth. Feedback was that the attendees didn’t like the venue – it was in work! However other colleagues could hear and see laughter from the group sessions and were curious. Soon there was the creation of a culture to talk about balance and resilience in the office. Outstandingly there was virtually no drop out – the ones who did drop out said it was due to sessions clashing with meetings rather than choice – so therefore wasn’t a true drop out. Miranda completed measures of participants before and after to determine whether the group was having the desired effect.

Groups consisted of sessions covering sleep hygiene, self-esteem/respect, lifestyle diaries (which were colour coded) and stealthy exercise. Miranda stated that stealthy exercise is essential forf the sedentary office based worker – plus “why preach about having all your fruit and veg and 40 minutes of exercise every other day when I don’t even do this myself!?”

The results from the pre and post measures demonstrated significant changes in depression, anxiety and presenteeism scores. On top of this morale in the office was on the increase. Staff sickness absence, although already low as these were well members of staff, also dropped. Feedback from the group was resoundingly positive with every session being rated as invaluable

The difference between running this type of group in an office environment rather that offering a call centre is that Occupational Therapists can offer adaption to people’s need rather than a one size fits all.

A paper collaboration with Professor Diane Cox is currently in process and will be submitted to the BMJ. After all, our conference take home message had to be “Publish! Publish! Publish! Good luck and I look forward to reading it in print!